摘要
目的:探讨前列腺健康指数(PHI)和前列腺健康指数密度(PHID)在PI-RADS评分3分前列腺癌诊断中的应用价值。方法:收集我院在2018年11月—2022年9月行前列腺穿刺术的112例PI-RADS v2评分为3分的患者病例资料。并将患者分为前列腺癌组(47例)和前列腺良性病变组(65例)。术前检测血清tPSA和PSA同源异构体2(p2PSA),并计算前列腺特异抗原密度(PSAD)、PHI和PHID。采用ROC曲线评估各参数在PI-RADS评分3分前列腺癌诊断中效能。结果:前列腺癌组p2PSA、PHI、PSAD、PHID相较于良性病变组均明显增高(P均<0.05)。ROC曲线分析结果显示,PHID、PHI、PSAD和p2PSA诊断前列腺癌的AUC分别为0.808、0.781、0.731、0.725,相较于tPSA(AUC=0.605)均有统计学差异(P均<0.05)。PHID、PHI、PSAD和p2PSA诊断临床有意义前列腺癌(csPCa)的AUC分别是:0.812、0.792、0.756、0.715,但只有PHID、PHI相较于tPSA有统计学上差异(P<0.001)。结论:与其他PSA衍生物相比,PHID和PHI在PI-RADS评分3分人群中诊断前列腺癌或csPCa的准确性上更具优势。
Objective:To explore the value of PHI and PHID in the diagnosis of prostate cancer with PI-RADS 3 lesions.Methods:Clinical data of 112 male patients who underwent prostate biopsy in our hospital during November 2018 and September 2022 were collected.The patients were divided into prostate cancer(PCa)group(47 cases)and benign prostate disease group(65 cases).tPSA,prostate-specific antigen isoform 2(p2PSA)were determined before prostate biopsy,and prostate specific antigen density(PSAD),PHI and PHID were calculated.ROC curve was used to evaluate the efficacy of various indexes in the diagnosis of prostate cancer with PI-RADS 3 lesions.Results:The PSAD,p2PSA,PHI and PHID were higher in the PCa group than in the benign prostate disease group(all P<0.05).ROC curve results showed that the AUC of PHID,PHI,PSAD,and p2PSA in the diagnosis of PCa were 0.808,0.781,0.731 and 0.725,respectively,which better than tPSA(AUC=0.605,all P<0.05).The AUC of PHID,PHI,PSAD and in the diagnosis of clinically significant prostate cancer(csPCa)were 0.812,0.792,0.756 and 0.715,respectively.The diagnostic value of PHI and PHID were better than that of tPSA(all P<0.001).Conclusion:Compared with other PSA derivatives,PHID and PHI have more advantages in the accuracy of diagnosing prostate cancer or csPCa with PI-RADS 3 lesions.
作者
王德明
沈肖明
陈启富
WANG Deming;SHEN Xiaoming;CHEN Qifu(Department of Urology of Longyan People’s Hospital,Longyan City,Fujian Province 361000)
出处
《医学理论与实践》
2023年第21期3620-3622,3632,共4页
The Journal of Medical Theory and Practice
